Healthcare Provider Details

I. General information

NPI: 1629830377
Provider Name (Legal Business Name): SHIFA HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 FAIRMONT AVE
MADISON WI
53714-1423
US

IV. Provider business mailing address

707 FAIRMONT AVE
MADISON WI
53714-1423
US

V. Phone/Fax

Practice location:
  • Phone: 608-335-0278
  • Fax:
Mailing address:
  • Phone: 608-335-0278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: K DEKKAR
Title or Position: VICE PRESIDENT
Credential: MBA
Phone: 608-335-0278